Association of electronic health records with cost savings in a national sample

To determine whether advanced electronic health record (EHR) use in hospitals is associated with lower cost of providing inpatient care.

National Inpatient Sample (NIS) and the Health Information Management Systems Society (HIMSS) Annual Survey are combined in the restrospective, cross-sectional analysis. We study patients who are 18 years or older and discharged from a general acute care hospital.

Using 2009 data and a cross-sectional design with a gamma distributed generalized linear model, a patient-level analysis is conducted with propensity scores to control for selection bias. Patient- and organizational-level variables are included as controls. The main outcome measure is total cost per patient admission and represents the amount that it costs the hospital to provide services based on the adjusted charges for an admission.

We include 5,047,089 individuals treated at 550 hospitals in the United States and represent a population-based sample. There are 104 (18.9%) hospitals included that use advanced EHRs. Patients treated in hospitals with advanced EHRs cost, on average, $731, or 9.66%, less than patients admitted to hospitals without advanced EHRs, after controlling for patient and hospital characteristics.

Hospitals that use advanced EHRs have lower cost per patient admission than comparable hospitals with similar case mix.